Medi Assist India Complaints & Reviews

Hello Sir/Ma'am, My name is Amaan Siddiqui. I have joined medi assist india TPA pvt ltd as an Asst Manager - BD on 16thApril 2012 in mumbai and was transferred to Noida office at same position at my will. I worked in Noida for about 3 months in Medi Assist and finally resigned on 4th jan 2014. I also got mail from the HR (Ms. Chahat Manchanda) confirming my resignation and my last working day and later i also got my relieving letter. Now its been more than a month starting from 1may 2015 i am continously calling Ms. Chahat Manchanda but she is not responding to my calls neither replying to my mails apart from the first call which she answered to know the reason for my call. My PF account number is KN/BN/25970/2899 . My pf account in maintained in bangalore. My pf amount is. 55k. Please help me in this issue so that processing of my pf becomes easy. Regards, Amaan Siddiqui

Dear Sir, My reference CLM no. 10941113, MAID NO. [protected] in the name of Dharvi Grover daughter of Ajay kumar still pending for the last 3-4 month. Why its delay, if any clarification required from your side, pls. let me know. You are requested to release my refund payment asap. Thanks ajay [protected]

> This is with regard to the cashless claim approval. My employee id is 321545 and i work in attra infotech. My father got admitted in St Johns hospital on wednesday 15th april. I applied for cashless facility and got an approval of 50000 against an estimated amount of 1.25 lac. Ack claim: 11070981. Today my father was supposed to get discharged and the final bill was sent to mediassist which amounted to 1, 93, 743. On this i got an approval of 20920. Ack no:11102252. The mediassist id is [protected]. According to my policy i should get 60% amount i.e. 1.16 lac from you. But i have got an approval of only 70920. I called mediassist customer care 5 times. They could not provide me any explanation and kept me on hold for more than 1 hour. Then i went to their office in bangalore. It got closed by the time i reached there. Because of this we had to delay the discharge till tomorrow. We went ahead with the treatment hoping that you would pay 60%. Now i dont have enough cash to get my father discharged from the hospital. I have only 40% of the total amount. I was really harassed by your customer care executive who promised me callbacks. But i didnt get any response from their side. Kindly provide me an explanation on the same and process my claim correctly as soon as possible.

Hi, Claim Registration No : D[protected], raised on[protected], no response so far, called multiple times on Bangalore number but no response. Can you please look in to it and approve the clam. Company : Tata Consultancy Services (TCS) Emp No: 480766 Emp Name : Yagante Varaprasad Thanks, -Varaprasad

My wife got admitted for a maternity on 22nd of January in an Emergency. She delivered a baby girl on 22nd of January. I called up mediassit on 22nd for intimation. It does not accept my intimation and wanted me to send an email. Since she was in emergency, I stayed day and night in the hospital, most of the offices were closed on 26th January hence I was able to send an Email only on Monday 27th of January. My question is why they did not accept the intimation on Telephone. It took me a series of 5 to 10 e-mails along with follow-ups to get the claim registered. My wife got discharged on 6th of February and I submitted the claim documents by 19th of February. I got a query on 1st of March that I need to submit the reason for delay. I wrote an application about the same I and submitted by 2nd of March. Mediassist did not provide me any status till 31st of March. On calling the customer care they told me that the claim has been repudiated and I need to contact a certain number[protected] in Bombay to take the case further. My question why do I have to call Bombay when I am staying in Bangalore. Trying for half and hour, ring goes and nobody responds on the number. 1-800 number is busy for hours at a stretch and If you dial the office number mentioned on site then security picks up the phone and tells that "The madam in charge has gone for lunch" Its a sheer case of customer harassment, not guiding the customer properly, not dealing through stipulated customer care and denying valid claims for no appropriate reasons. Never Ever insure through Medi Assist if you want a peace of mind and your claims to go through. My claim number is 10893124.

1. The certification of cash less hospitalization for the treatment of my son Mr Sanjay K S, Junior software Engineer, Coupons.com company (Employee Code - 11) for the Ankylosing Spondilitis was not approved by the Medi Assist India TPA Pvt Ltd and advised us to send the bills after treatment for reimbursement. 2. The treatment was given to Mr Sanjay K S, on 08.12.2014, in Bangalore Baptist Hospital, Hebbal, Bangalore – 560024 for the Ankylosing Spondilitis. 3.Accordingly, the original hospital main bill with detailed break up, reports and pre-numbered cash paid receipt, have already submitted to M/S Medi assist India, Bangalore on 30.12.2014 and the ORIGINAL bills/details were sent, given as below, i) The duly filled in reimbursement claim form ii) The split up expenditure details Bill No Bill date Particulars Amount (Rs) [protected].12.2014 Lab Charges 970.00 [protected].12.2014 Medicine charges 82411.00 [protected].12.2014 Medicine charges 60.00 Total Rs 83411.00 iii) The outpatient bill related to Lab charges dtd 05.12.2014 of Rs 970.00 iv) The Doctor’s prescription dtd 05.12.2014 v) The cash paid out patient pharmacy cash receipt dtd 08.12.2014 of Rs 82411.00 vi) The Emergency services treatment record and prescription dtd 08.12.2014. vii) The out patients pharmacy cash receipt dtd 08.12.2014 of Rs 60.00. viii) The outpatient bill for the charges of IV Injection/Infusion/KVO (Medicine) dtd 08.12.2014 of Rs 30.00 ix) The request letter for cash less hospitalization for Medical Insurance Policy 3. As regards the required Investigation reports, sought from Mediassist dated 08.01.2015, the data/information /details ie the Medical Report furnished from the company vide dated 13.01.2015. (copy enclosed) 4. And also it was requested for more information/clarification regarding the medical aspects from Dr Jacob Mathews V. DNB MD (Medicine), Consultant Physician and Rheumatologist of Bangalore Baptist Hospital, . Airport Road, Hebbal, Bangalore and Mail - [protected]@yahoo.co.in, Ph:[protected] Extn- 350) 5. The Insurance Company denied the reimbursement of medical expenses. But as per ‘Employee Benefits Manual’ in Coupons.com Policy, this exclusion is waived & all claims related to Pre-Existing Ailment Is payable from Day one of the policy. 6. It is hence requested to look in reg the reimbursement of medical expenses. Dated 25.02.2015 Yours Faithfully sd/- Enclosures: Siddappa K G 1. Reimbursement claim form Parent of Sanjay K S 2. Bills and prescriptions – 8 # 103/B, 6TH Cross, 3rd Main Road 3. Medical Report Ganganagara, Bangalore- 560032 4. Lab Report

Please note my daughter is in TCSand we had a claim regarding hospitalization and we have received trhe same.further check up was done.later asked to do MRI for further treatment. we have done the same and sent the bills for reimbursement.but is rejected.earlier claim we have received.if patient is unwell after thirty days .why claim has been rejected.patient cant be in hospital for months .pl look in to the matter

medi assist Id: [protected] emp. no: H2013RDG054 My sister Ms Vandana Baghotiya was hospitalized at Himgiri hospital Hyderabad and we have health insurance from Medi-assist. We paid the hospital bill at the time of discharge, our claim has been approved on 18th June 2014 but it has been almost 4 months, medi-assist has not reimbursed our claim, I have called 100's of time but they do not have any answer. Medi assist service has pathetic and worst service among others TPA's. You are requested to help us in this claim reimbursement process. Gireesh Baghotia Mb: [protected]

Dear Sir, I am a corporate employee and this complaint is with regards to my claim for my father's liver transplant surgery.I initiated cashless claim via hospital and the claim got rejected immediately.I called the customer executive(Mr.Arun) and he confirmed that the claim would be processed after receiving letter from hospital that reason for surgery is 'liver transplant'. I contacted Mediassist after a day to know the status and they have replied that claim is denied stating reason as 'alcohol'. when I took the policy, it was mentioned that all pre-existing aliments are covered. Here is the mediassist id: [protected] Policy No: 602200/46/14/[protected] Requesting justice in this case. Regards, Meenu

Dear sir/madam (Ranganadh & vijayawada opp:b.r.p. road manager) I don't know why this medi assist is dealing with these types of employer who scare of getting fined on them for the claim which they are looking for. FYI., the disease which you are saying "pre existing". Actually it was the years of marriage. I mean to say the marriage has been done before 3yrs. BTW you must go as per the rules but this is not fair. And its being very unfair to do like this which creating new problems in the claims. Regards, Asad Muhammed Mob No: 0091-[protected] / 0091-[protected] Past Mail for the manager: Dear ranganath, I have met Mr. G.V. Rao., Vijayawada and had a conversation as you told. But he is telling that the file is closed and you people can't open again. How is this happening. It looks like i am toy and you guys playing with me. How are you working and giving trouble to the customers. As you said to talk with Mr. G.V.Rao. But he is telling the other story to apply for "ODBUDSMAN" As you guys giving trouble and telling us to complain to ODBUDSMAN. This is not fair. For a genuine case., you guys making it difficult and closing the file. I don't angry with your response. Regards, Asad Mohammed Mob No: 0091-[protected] / 0091-[protected] Dear sir, Please find attached file of the documents related to the claim no: 9753622. Mrs. Syed Khader UnnisaBegum W/o. Asad Mohammed. As your letter requiring i am sending the First consultation papers of vijayawada. As i had a conversation with Mr. Dr. Mohan on phone call @ 24th april @ 12:04pm. And the reamining required documents will be given next month as i live in vijayawada and will be coming to vizag next month. so i just want to intimate about the other documents will bring next month on 9th May. So please revert as you get this mail as an acknowledgement from your side. Regards, Asad Mohammed Mob No: 0091-[protected] / 0091-[protected]

Dear sir
I hukam chand s/o sh sohan lal having a policy in medi assist. Nd my policy no is 233902/48/2015/480. I meet with in road accident. Nd mu doctor suggest me for operate . Nd they send the detail to your department. For cashless facilty. But my approvel is rejected. When i ask why it is rejected then they have a no proper answer for it. I call all the concern pepole any one has not a reason behind it. And i mail it to all your mail id. But get not a single reply. So i request you to plz take a immigiate action on it. So that i can get my treatment properly.

Thnx nd regard
Hukam chand
[protected]

ello Medi Assist,

How long will you take for processing settlement of an approved claim. See there are two reimbursement claims of mine one is approved but not settled and the other is awaiting for the settlement of first claim see the status below.

Claim 1 -- Status click http://www.myclaims.in/ClaimDetails.aspx?LiveClaimId=111E080B247F6EA9C0FD15A8E4C...⇄
Claim 2 -- Awaiting for the settlement of claim...

Hi,

I have medical insurance from Medi Assist India PVT LTD. I got dengue fever in October 2012.In same month applied for reimbursement, till now I didn't get that money.
If I call they will say your request in process.

Regards,
Siva B

We have submitted the claim for MAID: [protected] and have received the Claim number on our mobile as 9919911. After following up for more than a month, there is no progress with this claim. The registered phone numbers dont work either, and we have been trying to reach to check the status. Is there a better way to help the aged, who are in real need to check their claim status.

I hereby complaint that mediassist company is 100% fraud, because so many peoples are suffering for cash less recently i am suffering from last 4-5 days, for my wife operation each hospital saying that they have no tie up with mediassist or pending for renewal of contract, or saying you can claim thru re-embursment, how ever if any person have no source of money for instant treatment, then how a common man treat himself, pls lodge complaint against mediassist and get the necessary action against fraud company.


Harmohan singh
[protected]

from the past three months I make them call for the reimbursement process.

1) number which they have provided in website is not working

2) I call to the main branch once or twice in a week but all the time they gave me fake promise that " our internal verification " is working..And when i ask them that how much time will it take, thay always say " one week" .
they are not giving me proper answers and give me fake promises for that..It has been three months now but still i dont get my claim amount...FAKE...specially Ahemedabad Branch..

Dear Sir, We have submitted the claim request on 27.11.2013 to Medi Assist India TPA Pvt. Ltd. after which we submitted the Reply for the queries with your letter dated 05.12.2013 under reference number CCN#8334282 on 13.12.2013 at their Mumbai, Andheri Office through Courier Namely Ashok Courier numbered 54257812. It has been around 1 month and we have not received any feedback on my claim. The telephone numbers of andheri office as[protected] /01 /02 /03 /04 is also not reachable for last 1 month. My details are as under: Claimant Name: Manoj Lahoti Claim Amount: Rs. 15, 553 Insured Code: 47807927 Policy No.: 124500/48/2013/9792 with Oriental Insurance Company Limited, Mumbai Mob: [protected] Email: [protected]@gmail.com Pls. let me know the status of my claim as earliest. Regards Manoj Lahoti

I am also suffering the same problem with Medi Assist reimbursement claim process. From last 2 months my claim is under processing. When I call to their customer service they told me it is under processing, they demanded new documents everytime and at last they reject my claim. If they initially reject it, then I could save much money for claim formalities. I does not obtained claim amount but unnecessary spent Rs. 1000/- for postage printing etc.
So from my better experiences, I request every body don’t go for Medi Assist TPA.

Ganesh Manapure,
Policy No. 120100/34/13/04/00000014
Claim No. 8184702

My name is Madhu Keshava; working in Corporate Company since 2004. Earlier, our company was tied up with TTK Health Insurance and it was really good service we were getting and then the company had to tie up with Media Assist Health Insurance. My mother is a Neurology Patient. Every now and then, she suffers from continuous hiccups and vomiting. In the month of July, we had to admit her to nearby Sumathi Nursing Hospital where doctors tried their best to diagnose the reason for such issues and failed to find so; they confirmed she needs Psychological Treatment and the same was given. However, Medi Assist denied approving the expenditure. I had to take a loan from my family member and friends to cover up the expenditure. When checked with the Media Assist Customer Service and Hospital, they claim Medi Assist does not approve expenditure for Psychological diagnosis and treatment. After a week or so, we found some behavioral changes with my mother’s health and she fell down at home. We immediately rushed to Columbia Asia Referral Hospital where we were told there were the following issues: 01. Sub-acute Left Lateral Medullary Stroke 02. Severe Depression with acute Short Term Memory Loss 03. Left Fifth Metatarsal Base Fracture 04. Numbness in both the ties MRI Brain scan showed left lateral medullary infarct, was started on anti-platelets, statins with close monitoring of blood pressures. 2D ECHO seems to be normal with an injection; fraction of 60% while carotid Doppler showed no significant stenosis. Orthopedic consult was taken for left leg swelling, X-Ray done showed fracture of left fifth metatarsal base; crepe bandage was applied after the swelling reduced, she was advised to avoid weight bearing. Other relevant investigations were normal. Psychiatry consult was taken for her acute short term memory loss; she was diagnosed to have severe depression, counseled and prescribed antidepressants. Pre-authorization was sent by the Hospital and Medi Assist denied the request; which made me to contact them again. I was told by the Customer Service that the approval will not be given on Psychological Diagnosis. Doctor says, “Stroke is more of Neurology Diagnosis and not related with Psychological Issue”. I had to scan the doctor’s copy and fax it to Medi Assist; and had to make some 20-25 calls to get the initial amount approved and confirmed they will not approve 80% of the expenditure instead only 55%. Medi Assist has an article on “Standard Nomenclatures & Procedures for Critical Illnesses” which says: “Any cerebro-vascular incident producing permanent neurological sequelae. This includes infarction of brain tissue, thrombosis in an intracranial vessel, haemorrhage and embolisation from an extra-cranial source. Diagnosis has to be confirmed by a specialist medical practitioner and evidenced by typical clinical symptoms as well as typical findings in CT Scan or MRI of the brain. Evidence of permanent neurological deficit lasting for at least 3 months has to be produced.” If this is the case, why can’t they approve the complete 80% coverage the dependents are eligible for? I am in a position where I’ll have no option to pay the hospital bill if they ask me to do so at the time of discharge. Please help me and save my mother…!!!

This is regarding the Mediclaim policy (of my wife) 142000/34/12/01/00008384, with New India Assurance. I am holding the policy since Oct 2006. Last week, my wife had developed some problems for which we had seen the surgeon who advised surgery, and I proposed my mediclaim and cashless benefits. their hospital is authorised for cashless mediclaim. When they applied for the pre authorisation, there was a query put by the Medi Assist TPA Pvt ltd, (Query no 2967885), MA ID [protected]. The query was, kindly provide previous 2yr policy copies excluding current yr policy. SInce i am holding the policy with NIA since 2006, I dont have the copies of the previous year. When I called up the Medi assist Mumbai branch office the concerned person insisting the copies, when I told her I could not reproduce the copies, and was asking her regarding the above issues she hung up the phone. when i called back after much redials, and insisted to speak to the branch manager, they said she is not there then later told me she is busy in a meeting, after some time they told the concerned person went for lunch. I would like to know why the company dont keep my records, as I am with NIA for more than 6years. even though NIA changed the TPA from VIPUL to MEdiassist, its companies responsibilities to forward the records of the policy holders. Second issue is I was really upset and harrassed by the way the person on other side of the phone from Mediassist spoke to me, very rude behaviuour. Please do the needful and see to it that such TPA companies wont harass common people. Thankyou.